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. 2021 Dec;43(6):1403-1407.
doi: 10.1111/ijlh.13672. Epub 2021 Aug 9.

Vivax malaria detection using a parasitic red blood cell flag generated by the Sysmex XN-9000 hematology analyzer

Hee Jin Huh  1 , Jae-Woo Chung  1 , Seong Yeon Park  2 , Seok-Lae Chae  1
Affiliations

Vivax malaria detection using a parasitic red blood cell flag generated by the Sysmex XN-9000 hematology analyzer

Hee Jin Huh et al. Int J Lab Hematol. 2021 Dec.

Abstract

Introduction: A Sysmex XN-series hematology analyzer (Sysmex), the next generation up from the Sysmex XE-series, can provide information regarding malaria infection in the form of a parasitic red blood cell (pRBC) flag. This study aimed to determine the usefulness of the pRBC flag for early detection and follow-up in patients infected with Plasmodium vivax.

Methods: A total of 221 patients with fever for whom CBC and malaria microscopy had been requested were analyzed. Sixty-seven individuals were diagnosed with P vivax infection, and 154 were diagnosed with other febrile diseases. The sensitivity and specificity of the pRBC flag for malaria parasite detection and the relationship between parasite density and presence of the pRBC flag were determined. The concordance rate between malaria microscopy and pRBC flag in 147 follow-up cases was calculated.

Results: The pRBC flag was detected in 56 of 67 malaria patients (sensitivity, 83.6%; specificity, 100%). The patients with the pRBC flag at initial diagnosis revealed significantly higher parasite density than the patients without the pRBC flag (P < .05). The concordance rate between malaria microscopy and pRBC flag in the follow-up cases was 53.1%.

Conclusion: Considering its high sensitivity in malaria-suspicious patients, unexpected vivax malaria cases can be detected with the pRBC flag when CBC is done in a routine laboratory setting. The pRBC flag provided by the Sysmex XN series is a valuable tool for vivax malaria detection.

Keywords: Sysmex XN-9000 hematology analyzer; malaria; pRBC flag.

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References

REFERENCES

    1. WHO. World malaria report 2019. https://www.who.int/publications-detail/world-malaria-report-2019. Accessed 2019
    1. KCDC. Infectious disease portal. http://www.cdc.go.kr/npt/biz/npp/ist/simple/simplePdStatsMain.do. Accessed 2020
    1. WHO. Guidelines for the treatment of malaria. https://www.WHO.int/malaria/publications/atoz/9789241549127/en/. Accessed 2015
    1. Huh HJ, Oh GY, Huh JW, Chae SL. Malaria detection with the Sysmex XE-2100 hematology analyzer using pseudoeosinophilia and abnormal WBC scattergram. Ann Hematol. 2008;87:755-759.
    1. Mubeen KH, Devadoss CW, Rangan RA, Gitanjali M, Prasanna S, Sunitha V. Automated hematology analyzers in diagnosis of plasmodium vivax malaria: an adjunct to conventional microscopy. Mediterr J Hematol Infect Dis. 2014;6:e2014034.

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